What Is Endo Belly? Experts Explain

If you have digestive issues, you may experience bloating. For people with endometriosis, severe bloating can be painful and last for days or weeks. This distressing symptom is commonly known as endo belly.

Endometriosis is a disorder in which tissue similar to the tissue that lines the uterus grows outside the uterus in places where it doesn’t belong. But what is endo belly, and how can you treat it? Also, how can you tell if it’s a type of bloating everyone experiences, or if it’s something more serious? Here, experts explain everything you need to know.

What is endo belly?

While it may not be a true medical term, those suffering from endometriosis are all too familiar with the term “endo belly,” which is painful bloating and swelling of the abdomen before and during a period, says women’s sexual health expert Dr Sherry Ross.

Endo belly is often more severe than typical bloating and can cause discomfort, pain, and swelling in the lower abdominal region for varying lengths of time prior to menstruation, adds gynaecologist Dr Anat Sapan.

“This occurs as a result of inflammation and gas accumulation, mimicking symptoms of gastrointestinal disorders like irritable bowel syndrome,” she explains.

Around 1 million Australians live with endometriosis at some point in their life, reports Endometriosis Australia.And because symptoms vary and can be dismissed as period pain, diagnosis takes on average seven years, reports Jean Hailes.

Endo belly symptoms

Symptoms of endo belly can vary from person to person, but Dr Ross says these are typical signs to look out for:

Painful bloating
Swelling
Pelvic/abdominal pain
Severe distension lasting hours, days or weeks

In addition to the typical symptoms of endometriosis which include pain, heavy period bleeding, and infertility; uncomfortable and embarrassing gastrointestinal symptoms can also occur, Dr Ross explains. “Disruptive intestinal symptoms include bloating, nausea, diarrhoea, and constipation.”

Emotional and mental effects of endo belly

Many people suffering from endometriosis and endo belly also experience depression and anxiety from the chronic and painful symptoms associated with this inflammatory disease, says Dr Ross.

“For some women, the endo belly can appear similar to a pregnancy in the second or third trimester.” Every woman has a different presentation of endo belly, but all have one thing in common; it’s disruptive and uncomfortable, she adds.

Causes of endo belly

Endo belly is a symptom of endometriosis, a condition where endometrial cells, or cells resembling the cells lining the uterus, grow outside of the uterus, explains Dr Sapan.

“During menstruation, these satellite cells react the same way that the endometrial cells respond to the decrease in hormones, causing inflammation and swelling.” Depending on the location of these cells, the symptoms will differ, she explains.

When it comes to endo belly bloating, this typically occurs when endometrial implants that normally line the inside of the uterus are found on organs in the pelvis and on the intestines, notes Dr Ross. “How the intestines react to these implants is variable, person to person,” she says.

The exact cause of endo belly is not exactly known, but there are some theories to the cause of this phenomenon, adds Dr Ross. “One thought is the pelvic endometrial implants bleed inside the abdomen each month causing inflammation and bloating. Another theory is that the intestines have an increased sensitivity to the monthly effect of the endometrial implants causing the endo belly,” Dr Ross explains.

How to treat and prevent endo belly

Doctors can diagnose endometriosis with a surgical procedure called a laparoscopy, says Endometriosis Australia.

Treating an endo belly can be challenging and frustrating, says Dr Ross, and working with an endometriosis specialist and dietician may be your best bet. Still, some lifestyle changes can help ease your symptoms.

“Avoiding inflammatory foods and following a low FODMAP diet is often suggested to help your intestinal tract move easily,” says Dr Ross.

As well as changes to your diet, managing endo belly can also involve medications, surgical interventions, and alternative therapies, says Dr Sapan. “Often treatment would emphasise on stopping the menstrual cycle from occurring using continuous oral contraception.”

Adopting an anti-inflammatory or FODMAP diet can alleviate bloating and inflammation, while NSAIDs (like ibuprofen) or hormonal treatments address endometriosis symptoms, she adds. Engaging in pain and stress relief techniques may also help relieve endo belly discomfort, says Dr Sapan.

Surgical options like laparoscopy remove endometrial growths. If a patient is moving forward with surgery because there are adhesions found on the colon, those adhesions are cut so that the bowel can freely move, explains reproductive endocrinologist and gynaecologist Dr Barbara McGuirk.

If you are prone to endo belly, you may always have it until your endometriosis is properly diagnosed and treated, says Dr Ross. “For some, the endo belly may never go away until you reach menopause when your periods ultimately go away along with your endometriosis.”

Since the exact cause of the endo belly is still a mystery, controlling it can be challenging, says Dr Ross. “Controlling an endo belly may mean controlling your endometriosis.” Containing and controlling the effects of the endometrial implants through medical supervision and an anti-inflammatory diet may control the disruptive symptoms of the endo belly, she explains.

Other possible causes of endo belly symptoms

If you are experiencing severe bloating but you don’t believe you have endometriosis, your symptoms may be due to something else. Dr Ross says the other causes of a bloated belly may include:

Discuss your symptoms with your doctor to help determine the cause and treatment options.

When to see a doctor for endo belly

Endo belly is not necessarily dangerous but it’s dangerously painful, both physically and mentally for many women, says Dr Ross. “If you suffer from endo belly, it’s never too early to create a management strategy for when disruptive symptoms do occur.”

Dr Ross suggests being your best healthcare advocate and meeting with your doctor to create a roadmap on what to do with uncomfortable endometriosis symptoms.

For endometriosis, there is no one stop fix, says Dr McGuirk. This condition is multifaceted and you need to have all of these specific things addressed; ”not only endo belly but your pelvic pain, long-term and short-term treatments, discussion about fertility potential if that is important to you.” So, finding a doctor who will do all of that for you is essential, says Dr McGuirk.

“Never suffer in silence, help is available for your disruptive and uncomfortable symptoms caused by this chronic disease,” Dr Ross advises.